Measuring FeNO

Asthma is often misdiagnosed or under-diagnosed

Obtaining an accurate asthma diagnosis can be a challenge as many diseases present with symptoms similar to asthma.4 Traditional methods of asthma assessment only give part of the picture, as they are only indirectly associated with airway inflammation.5

In addition, conventional evaluation methods such as peak flow and spirometry only measure airflow and not airway inflammation. They are effort dependent and sometimes the results can be difficult to interpret.6 Likewise, symptom assessments are subjective and lack sensitivity.7

As a result, asthma is often misdiagnosed or under-diagnosed. Studies of adults diagnosed with asthma suggest that up to 30% do not have clear evidence of the condition. Some may have had asthma in the past, but it is likely that many will have had an incorrect diagnosis.8

FeNO adds a new dimension to traditional clinical tools

FeNO testing is non-invasive and has proven more reliable in predicting inflammation and steroid responsiveness than spirometry, bronchodilator response, peak expiratory flow, or airway hypersensitivity.9 It enhances the ability of the clinician to make better treatment decisions, avoiding empiric steroid trials and unnecessary long-term treatment.10,11

The British Thoracic Society updated their guideline on the management of asthma in 2016 to highlight that a positive FeNO test suggests eosinophilic inflammation and provides supportive evidence for an asthma diagnosis.12

The new guideline on asthma diagnosis and management from the UK’s National Institute for Health and Care Excellence (NICE) endorses the use of FeNO testing in Primary Care, as part of comprehensive diagnostic algorithms for adults, children and young people. The health economic model included in the NICE guideline concluded that FeNO testing was part of the most cost-effective diagnostic pathway for adults.13

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